Concussions and Head Injuries in Student Athletes (K-12)

The laws addressing student athletes with suspected concussions or head injuries were recently amended to: (1) provide for a “graduated return-to-play protocol”; and (2) limit the duration and amount of full-contact football practices. In making these changes, the Legislature expressed concern with the number of concussions or head injuries that go undetected due to a lack of recognition of symptoms or intentional underreporting of symptoms. Schools, districts, or athletic leagues may adopt and enforce rules that provide for a higher standard of safety for athletes than the legal requirements.

LEGAL UPDATE

May 15, 2015

To:  Superintendents, Member School Districts (K-12)

From:  Jennifer E. Nix, Schools Legal Counsel

Subject:  Concussions and Head Injuries in Student Athletes

Memo No. 11-2015


The laws addressing student athletes with suspected concussions or head injuries were recently amended to: (1) provide for a “graduated return-to-play protocol”; and (2) limit the duration and amount of full-contact football practices.[1]  In making these changes, the Legislature expressed concern with the number of concussions or head injuries that go undetected due to a lack of recognition of symptoms or intentional underreporting of symptoms.[2]  Schools, districts, or athletic leagues may adopt and enforce rules that provide for a higher standard of safety for athletes than the legal requirements.[3]

Return-to-Play Protocol Requirements

Existing law requires that any athlete who is suspected of sustaining a concussion or head injury in an athletic activity must be immediately removed from that activity for the remainder of the day.[4]  The athlete cannot return to the activity until he or she is evaluated by and receives written clearance from a “licensed health care provider.”[5]  The amended law specifies that a licensed health care provider must be trained in the management of concussions and acting within the scope of his or her practice.[6]

The amended law requires that, if a licensed health care provider determines that an athlete has a concussion or brain injury, the athlete must complete a “graduated return-to-play protocol.”[7]  The athlete may not return to the activity for at least seven days spent under the supervision of a licensed healthcare provider.[8]  This new provision requires a student athlete who receives a concussion or brain injury during practice or competition to return to practice or competition gradually and progressively while under medical supervision in order to minimize risks and allow the brain to recover properly.  This timeline is only a minimum timeline, and coaches should always be cautious when returning concussed athletes to play.

In response to this change in the law, the California Interscholastic Federation (“CIF”) updated its concussion protocols bylaw, Bylaw 503.H.  CIF also created a Concussion Return-to-Play Protocol and a Grade Concussion Symptom Checklist for district use.  Additionally, CIF developed a Concussion Return-to-Learn Protocol for district use, and a Physician Recommended School Accommodations Following Concussion form for an injured athlete’s licensed health care provider to fill out.  These documents are all attached to this legal update, and are also available at http://cifstate.org/sports-medicine/concussions/index.

Limits on Full-Contact Practices

The amended law also limits full-contact football practices for middle and high school teams.[9]  Specifically:

·       Teams may have no more than two full-contact practices per week during the preseason and the regular season.

o   A full-contact practice is one that has drills or live action involving collisions at game speed and players executing tackles and other activity typical of an actual tackle football game.

o   The full-contact portion of practice may not exceed 90 minutes in a single day.

o   A team camp session is considered a practice.

o   “Preseason” is defined as the 30 days prior to the first interscholastic football game or scrimmage.

o   “Regular season” is defined as the period from the first interscholastic football game or scrimmage to the completion of the final interscholastic football game of the season.

·       Teams may not hold full-contact practice during the off-season.

o   As stated above, a team camp session is considered a practice.

o   “Off-season” is defined as the period from the end of the regular season to the beginning of the preseason.

Additional Requirements

As a reminder, existing law requires that all high school coaches for any sport, paid or volunteer, receive training in CPR and first aid that includes basic training in the signs and symptoms of concussions and the appropriate response to concussions.[10]  Existing law also requires districts to distribute an information sheet on concussions and head injuries to student athletes and parents each school year.[11]  The student and his or her parent or guardian must sign and return the concussion information sheet prior to initiating practice or competition.[12]  CIF has a concussion information sheet for Districts’ use.[13]

Recommended Actions

Districts are encouraged to review the CIF protocols regarding return-to-learn and return-to-play when available, and to establish procedures and protocols for evaluating, monitoring, and treating head injuries when they occur, and for evaluating and monitoring athletes following determination of a concussion or brain injury.  Prior to any summer football practices, districts are encouraged to communicate the new limits on contact football practices to all middle and high school football coaches, including volunteer coaches, and to make sure the coaches are clear on when they may begin full-contact practices.

Please contact our office with questions regarding this Legal Update or any other legal matter.

Attachments

 

The information in this Legal Update is provided as a summary of law and is not intended as legal advice.  Application of the law may vary depending on the particular facts and circumstances at issue.  We, therefore, recommend that you consult legal counsel to advise you on how the law applies to your specific situation.

© 2015 School and College Legal Services of California

 All rights reserved.  However, SCLS grants permission to any current SCLS client to use, reproduce, and distribute this Legal Update in its entirety for non-commercial purposes.



[1]Assembly Bill 2127 (effective Jan. 1, 2015).

[2]Id.

[3]Education Code section 35179.5(d).

[4]Education Code section 49475(a)(1).

[5]Id.

[6]Education Code section 49475(b).  The California Interscholastic Federation provides that a licensed health care provider must be a medical doctor or a doctor of osteopathy.  CIF Bylaw 503.H.

[7]Education Code section 49475(a)(1).

[8]Id.

[9]Education Code section 35179.5.

[10]Education Code section 35179.1.  CIF has recently amended its bylaws to require that coaches receive training in sudden cardiac arrest and has added a sudden cardiac arrest protocol to its bylaws.  See CIF Bylaws 22.B.(9); 503.J (attached).  These changes were suggested by CIF’s Sports Medicine Committee, and are not related to any legislative changes.  The suggested biannual training on sudden cardiac arrest and related protocol, sometimes referred to by CIF as training on automated external defibrillators, is not required by law.

[11]Education Code section 49475(a)(2).

[12]Id.

[13]The form is available at http://cifstate.org/sports-medicine/concussions/CIF_Concussion_Info_PPE_packet.pdf, and is also attached to this legal update.